Provider Demographics
NPI:1275068074
Name:SANYANG, YANKUBA A (NP)
Entity type:Individual
Prefix:
First Name:YANKUBA
Middle Name:A
Last Name:SANYANG
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 FORD PKWY
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-1931
Mailing Address - Country:US
Mailing Address - Phone:888-290-1209
Mailing Address - Fax:
Practice Address - Street 1:2000 RAHNCLIFF CT STE 400
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-3470
Practice Address - Country:US
Practice Address - Phone:888-290-1209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-29
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5098363LG0600X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology